Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Overcoming the heat-sink phenomenon: successful radiofrequency thermal ablation of liver tumors in contact with blood vessels

1.

Departments of Radiology, Sotiria Hospital Athens, Greece

2.

Departments of Radiology, Red Cross Hospital Athens, Greece

3.

Departments of Radiology, Red Cross Hospital Athens, Greece

4.

Department of Pathology, Ippokrateio Hospital, Athens, Greece

Diagn Interv Radiol 2008; 14: 51-56
Read: 399 Downloads: 198 Published: 03 September 2019

Abstract

PURPOSE
To evaluate the efficacy and safety of computed tomography (CT)-guided radiofrequency thermal ablation (RFA) of liver tumors (hepatocellular carcinoma and liver metastases) >3 mm in diameter that were in contact with blood vessels.

 

MATERIALS AND METHODS
During a 3-year period RFA was performed in 28 patients (age range, 36–83 years; male/female ratio, 17:11) with liver tumors (primary and metastatic) that were in contact with blood vessels >3 mm in diameter. Tumor diameter ranged from 1.7 to 5.1 cm. To evaluate the immediate response, dual-phase dynamic CT images were obtained after intravenous contrast material administration. Imaging follow-up was at 1, 3, 6, and 12 months post-RFA, and every year thereafter.

 

RESULTS
All of 28 patients were treated with a total of 36 sessions. In 22 (79%) of the patients, complete ablation of the tumor was achieved. The remaining 6 (21%) patients showed irregular peripheral enhancement and underwent a second session. At 1-year follow-up 2 of the tumors showed a recurrent lesion and a new ablation was performed. The local tumor progression rate at 1-year follow-up was 8.7% and disease-free survival was achieved in 82.1% of the patients. Complications occurred in 4 patients (14.3%); 2 patients presented with a small sub-capsular hematoma, and 2 patients had a partial liver infarction.

 

CONCLUSION
RFA is a safe and effective method, even with highrisk tumors adjacent to large blood vessels, which can lead to good results with minimal complications and a low rate of tumor progression.

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EISSN 1305-3612